Tuesday, August 31, 2010

Majority of Caesareans Are Done Before Labor

Published: August 30, 2010

A new study suggests several reasons for the nation’s rising Caesarean section rate, including the increased use of drugs to induce labor, the tendency to give up on labor too soon and deliver babies surgically instead of waiting for nature to take its course, and the failure to allow women with previous Caesareans to try to give birth vaginally.

Thirty-two percent of all births in the United States — nearly 1 in 3 — now occur by Caesarean section. The operations have been increasing steadily since 1996, setting records year after year, and have become the most common surgery in American hospitals. About 1.4 million Caesareans were performed in 2007, the latest year for which figures are available. The increases have caused debate and concern.

The concern arises because Caesareans pose a risk of surgical complications and research has found that they are more likely than normal births to cause problems that can put the mother back in the hospital and the infant in intensive care. Risks to the mother also increase with each subsequent Caesarean, because it raises the odds that the uterus will rupture in the next pregnancy, which can seriously harm both the mother and the baby.

Caesareans also increase the risk of dangerous abnormalities in the placenta during later pregnancies, which can cause hemorrhaging and lead to a hysterectomy. Repeated Caesareans can make it risky or even impossible to have a large family. In addition, costs for a Caesarean are nearly twice those for a vaginal delivery.

Most women who have had one or even two Caesareans can at least try to give birth vaginally, and studies have found that 60 to 80 percent succeed. But vaginal births after Caesarean sections have become increasingly uncommon.

Worries about the ever-increasing Caesarean rate led the National Institutes of Health to form a Consortium on Safe Labor, which performed a detailed analysis of electronic records from 228,668 births at 19 hospitals in the United States from 2002 to 2008. The study is the first to analyze how often Caesareans were performed before women went into labor (more than half the time) and how often after labor had begun.

The results were published this month by the American Journal of Obstetrics and Gynecology, and described in a telephone briefing by two of the authors, Dr. Jun Zhang and Dr. S. Katherine Laughon, from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Dr. Zhang said one thing that surprised him about the study was that a third of first-time mothers were having Caesareans. Although it was known that the overall Caesarean rate was 32 percent, some of that was thought to be due to repeat Caesareans.

The main reason for a Caesarean was a prior Caesarean. But in women who have not had Caesareans before, one factor that may increase the risk is the use of drugs to induce labor. The practice has been increasing, and the study found that induced labor, compared with spontaneous labor, was twice as likely to result in a Caesarean.

In the study, 44 percent of the women who were trying vaginal delivery had their labor induced. When Caesareans were done after induction, half were performed before the woman’s cervix had dilated to six centimeters, “suggesting that clinical impatience may play a role,” the authors wrote. Full dilation is 10 centimeters, and a Caesarean before six centimeters may be too soon, the researchers said.

Like other studies, this one found that few women were offered a chance to try vaginal birth after Caesarean.

“Physicians and patients may be less committed” to the vaginal births, the authors said.

Dr. Zhang said it appeared likely that the Caesarean rate in this country would keep increasing, though he said he hoped it would never match the rates in Brazil (70 percent) or China (60 percent). If there is any hope of reducing the rate in the United States, or at least slowing the increase, he and his colleagues said, the key is to lower the rate among first-time mothers and increase the rate of vaginal birth after Caesarean.

Monday, August 30, 2010

Well folks, the third trimester is here! I officially can't breathe most of the time since Miss M decided that my ribcage makes a good pillow and most days I think she is trying to break out of my belly button.

I have been busy reading Ina May every night, watching You Tube videos of natural childbirth to get me in the mindset that it can be done, and reading lots of posts on my BabyCenter VBAC board- especially the success stories!

One of the most inspirational and pretty videos I have seen yet is this one. Not only is the woman totally in control of her birth, but she is SINGING! It is one of my favorite songs called The Irish Blessing.

Tuesday, August 24, 2010

When you talk about a VBAC two words that get quickly ingrained in your head is uterine rupture. The risks of, that dangers of, the possibility of.... it is the first thing my former OB brought up and purposely inflated all details about it to scare me out of even researching a VBA2C for this baby. When I called, and called, and called other OB offices and they promptly denied me, uterine rupture was the reason for them saying a very quick NO!
But really, when you think about it... yes, there is a risk. But isn't there a risk in everything we do? When we choose to drive, fly, eat at a restaurant, have sex, park downtown, etc.... there are all risks associated with these actions. Rarely though are you in a hospital where if the unthinkable does happen you are in good hands.
Here are some statistics to put it all in perspective: (from here)

Your risk of dying in a car accident, over the course of a lifetime, is between 1 in 42 and 1 in 75. This is roughly 4 to 5 times greater than the risk of uterine rupture.

You're about twice as likely to have your car stolen (that's an annual risk) than to experience a uterine rupture.

Your odds of being murdered are 1 in 140 over the course of you lifetime. That's 2 times more likely than the risk of rupture.

The annual risk of having a heart attack in 1 in 160, 2 times more likely than rupture.

If you're a smoker, your risk of dying from lung cancer is 1 and a half times more likely than a VBAC mom having a uterine rupture during her labor.

You're about 17 times more likely to contact an STD this year than having a uterine rupture, more likely to contract gonorrhea as well.

You're 13 times more likely to get food poisoning than to rupture.

You're more likely to have twins than to rupture. Odds of twins: 1 in 90. That's about 3 1/2 times the likelihood of uterine rupture.

If you ride horseback, you're 3 times more likely to die in a riding accident than you are to experience uterine rupture.

If you ride a bike on the street, you are 4 times more likely to die (annual risk) than to suffer a uterine rupture.

Having a serious fire in your home during the next year is twice as likely as experiencing a uterine rupture.

You're 10 times more likely to win at roulette than you are to have a uterine rupture.

If you flip a coin, you're more likely to get heads (or tails) 8 times in a row than you are to rupture.

The risk of cord prolapse is 1 in 37 (2.7%) or nearly 10 times more likely than that of uterine rupture.

And a final irony (heads up those of you who want a doctor to give his/her opinion on the likelihood of rupture next pregnancy!):

You're 6 times more likely to have a doctor who is animpostor than you are to suffer a rupture. 2% of docs are phonies (1 in 50), according to several sources I found.

So, instead of worrying about rupture, why not take a few minutes to check up on your doctor's credentials? :) It'd be a more profitable use of your time, and a substantially more likely cause for alarm.

Here's a few more I came across on my own (keep in mind the odds of uterine rupture are roughly 1 in 200 or .5% (though I have seen it as low as .3% or 4%)):

Monday, August 23, 2010

I spotted this article in the Prenatal Yoga website and thought I would share it with everyone since it is such simple things like these that can make a HUGE difference in your labor experience!

Here are some ideas to try to help make your labor more comfortable, less painful and (hopefully) shorter.

1. Heat – I typically bring a hot water bottle with me to births. However you can use a hot rice sock or a warm wash cloth. Most laboring women like to apply the heat to the lower back or lower abdomen. When using heat, the support people around should make sure that the heating device is not too hot, test it on your inner arm before applying to the laboring woman’s body.

2. Cold – Some women respond better with a cool touch than a hot one. If that is the case, I recommend using an old fashion ice bag, a latex glove filled with ice chips, a frozen rice sock, a frozen bottle of water or a cold wash cloth. With the cold packs, I recommend placing or rolling these items on the mother’s lower back, or draping the cold wash cloth on the back of her neck.

How cold helps? “Cold is especially useful for musculoskeletal and joint pain. Cold decreases muscle spasm - longer than heat. It reduces sensation in the area by lowering tissue temperature, which slows the transmission of pain and other impulses over sensory neurons.” (Therapeutic Heat and Cold by J.F. Lehmann)

3. Shower or Bath – The feeling of warm water on your belly and back during labor can be a life saver! You may find that the water helps alleviate the pain and distracts you from such intense sensation. This would be especially good if you are having back labor. If the laboring woman is too tired to stand in the shower, place a stool or the birth ball in the shower or tub. Again, it is important for the partner or doula to monitor the temperature of the water and make sure it is not too hot. Because the bath or shower is so relaxing, I typically do not use this method of pain relief until the mother appears to be in active labor because it can slow labor down. However, if the early stage of labor is rather drawn out and the mother needs to relax, a bath or shower could be the perfect solution.

How the shower or bath helps? The warmth of the water on the mother’s body can be very mentally and physically relaxing. The water pressure can help alleviate muscle tension and back pain. “The effects of immersion in water may be summarized as the following: bathing provides buoyancy and warmth, both of which often bring immediate pain relief, relaxation, lowering of catecholamines, increases oxytocin, and more rapid active labor progress. (The Labor Progress Handbook by Penny Simkins and Ruth Ancheta)

4. Birth Ball – The Birth Ball is a large physiotherapy ball- typically 65 cm is appropriate for the average size woman. It can be used prior to labor to help alleviate back pain and promote an ideal fetal position. Many women are surprised by my advice to bring it to the hospital with them.

How the Birth Ball helps? During labor it is particularly useful to sit on the ball which promotes a natural swaying and rocking of the pelvic. This motion can encourage fetal descent and help alleviate lower back tension, as well as provides gentle support for the perineum. As an alternative to being on all fours, lean over the birth ball. This position encourages an anterior position of the baby and takes pressure off the mother’s back. You can also place the ball on the bed, table or couch and leans over it while standing and swaying your hips. This helps use gravity and again encourages fetal descent.

5. Change Positions Often – Changing position every 20-30 minutes may help reduce the woman’s pain significantly. There are several common positions for women to use during labor. Side lying, semi seated positions, upright seated, standing and leaning forward, kneeling and leaning forward, all fours (hands and knees), child’s pose, asymmetrical lunge in the upright position and squatting.

How change of position helps? Changing positions often gives the woman a chance to experiment and discover what positions seem comfortable and effective, but also allows the baby to move around in the pelvis, encouraging fetal descent and moving into an ideal birthing position. Also, if the labor is slowing down, changing positions may help the mom get back into a rhythm that is comforting and shift the baby into the most advantageous position for passage through the pelvis.

How setting the stage helps? “What is needed for effective labor with lowered levels of stress hormones is a comfortable, dimly lit, cozy space that allows you to access the part of your primitive brain that sets up the process of hormonal ebb and flow and facilitates the smoothest functioning of the normal birth process. We share this need for privacy during labor with virtually all other female mammals.” (Ina May’s Guide to Childbirth, by Ina May Gaskin)

7. Massage – I have met very few laboring women that do not appreciate a reassuring and relaxing massage. You do not need to be a professional massage therapist to give some one you love a little helpful massage. All you have to do is move into the massage with the intention of helping to release tight muscles and alleviate pain and most importantly, watch for the woman’s response. She may not verbally tell you if you are doing it right, so watch for her facial expressions and sounds.

How massage helps? Massage has been credited with helping to reduce pain, anxiety and fear by increasing endorphin levels in the body. Several of the common areas that the laboring mom may enjoy to have massaged are the lower back, neck, shoulders, hands and feet. Also keep in mind, the more relaxed you are, the less painful the contraction will seem. The more stressed you are, the more painful the contractions will seem. Final tip- be prepared with lotions or oils that smell good to you. Just the smell of the products may help relax you.

Sunday, August 22, 2010

In September 2006 I was trying to convince my husband that another child would be good for our little family and a year later that is exactly what happened. However, when I got pregnant with Amelia, my OB had already decided that another c-section was my only option and refused to discuss the possibility of a VBAC. I had never thought to question her or research my options because I didn't think I had any. (This is all moot point of course because AJ was born via emergency c-section due to distress at 37 weeks- her heart rate was in the 200's!)

But, had I done any research hopefully I would have come across this wonderfully written article by Dr. Mark Landon that was posted in the Ohio State University Medical Center.

"In his most recent analysis of multicenter data collected over four years, Dr. Mark Landon evaluated the risk of complication and success of VBAC in women who had undergone more than one prior cesarean delivery.

The 19-academic center study was led by Landon and conducted through the National Institutes of Health, Maternal Fetal Medicine Units Network. Its data included more than 45,000 patients with previous cesarean section, which included almost 18,000 women undergoing a trial of labor or an attempt at VBAC.

Landon found that the risk of uterine rupture was 0.9 percent in cases of women with a history of multiple prior cesarean deliveries undergoing a trial of labor, compared with 0.7 percent in the cases of patients who had experienced only one previous cesarean delivery. These data challenge the notion that women with more than one prior cesarean are at dramatically increased risk for uterine rupture with a VBAC attempt."

Huh.... interesting that not only does this state the risks of VBACing with 1 c-section but multiple, AND states that the risk increases only minimally with multiple surgeries. And this was back in 2006! Before ACOG released the new guidelines stating basically the same thing- that women with multiple c-sections CAN benefit from trying for a vaginal birth.

This study is really good because it is a huge pool of women and shows what the true risk of rupture is plus how small the risk of a catastrophic rupture (fetal death or brain damage) is. It is just too bad that it took ACOG 4 years to take notice and change its views on VBAMC.

Wednesday, August 18, 2010

Hi all!!!
Man oh man is it getting busy at my house! We just celebrated my oldest daughter's birthday on the 16th, went raspberry picking, have been getting ready for school which starts in one week, and all the while teaching dance among all my other jobs.... whew!
Anyhow, I was on my VBAC Support board on Babycenter and saw this article and got chills. I mean, I knew that this kind of medical battery happened... but the stories this woman could tell is so horrifying that I really want to take some kind of action. The bottom line is that this kind of thing should not happen...

Anyone who has been to a doctor in the last dozen years has seen and signed the HIPAA (Health Insurance Portability & Accountability Act) form given out by their doctor or hospital. The HIPAA Privacy Rule was specifically designed to protect the privacy and integrity of personal health information collected by medical professionals about their patients.

Essentially this means that it is illegal to release the specifics of a patient case you may have either attended or witnessed. Thinking in terms of a laboring woman, what happens in her hospital room stays in her hospital room.

Doulas are not bound to HIPAA, but we do carry a professional code of ethics which makes it unprofessional to openly discuss our clients’ cases. Some of us may gather in small circles to privately work out our thoughts on situations we may have been in, and try to grow our knowledge base by sharing experiences. However, it is considered quite unprofessional to openly discuss any identifying details of a specific mother’s birth experience.

Of course, privacy is essential to trust. A woman cannot trust a provider who would willingly pass the details of her case around the internet for all the world to see. For the most part, it is nobody’s business what happens during her labor.

Well, unless it IS.

Speaking in generalities, because I will not discuss specific cases, I can tell you that some things I’ve witnessed as a doula in a labor room have been nothing short of a crime. Women have the right to informed consent and refusal, and I have seen cases where that right is violated over and over again throughout a labor. According to the American Medical Association,

“Informed consent is more than simply getting a patient to sign a written consent form. It is a process of communication between a patient and physician that results in the patient’s authorization or agreement to undergo a specific medical intervention…
…This communications process, or a variation thereof, is both an ethical obligation and a legal requirement spelled out in statutes and case law in all 50 states.”

So what happens when a woman flatly refuses to give consent, and a physician performs a procedure without her authorization and against her will? Katherine Prown, Ph.D. tells us,

“The legal doctrine of informed consent/refusal developed from the laws on battery. In a medical setting battery is defined as touching or treatment that occurs without obtaining proper informed consent; medical treatments that are substantially different from the ones a patient consented to; treatment that exceeds the scope of consent; or treatment provided by a physician other than the physician who obtained the patient’s consent. As case law on informed consent/refusal evolved, however, the courts increasingly defined lack of proper consent as a matter of negligence. Negligence requires that the lack of proper consent or failure to meet the standard of care resulted in emotional or physical harm worthy of monetary compensation. In certain circumstances in which monetary compensation is not an issue, though, the laws on battery may still apply.”

Given this, I have borne witness to cases where a woman’s rights are so flagrantly violated that it seems like an obscene injustice not to tell the world about what happened to her. But once the labor is over, the dozen or so people in that room simply move on to another labor, and because of privacy laws like HIPAA, nothing that happened is ever shared with the public.

You might be asking “Is it really that bad? Can it really, seriously be that bad?” You tell me. (**Trigger Warning**)

I have seen a mother flat out refuse a procedure and/or treatment and the doctor say, verbatim, “You can say no, but we’re doing it anyway.” And they did. And nobody in the room could stop them.

I’ve seen the mother’s parents get into yelling matches with the nurse or doctor because the medical staff constantly coerced or threatened the laboring woman to the point of emotional distress.

I’ve seen a doctor stand over a woman and force her to “pre-authorize” a major intervention that was neither wanted, needed, or ever actually used during the labor, and refuse to leave the room until her signature was on the paper – giving her no time to contemplate the decision or discuss it with her family.

I’ve seen a woman scream “No, stop!” while trying to kick a doctor’s hands out of her, as she tries climbing up the back of the bed to escape, while the doctor ignored her pleas and reaches farther into her vagina – blood curdling screams fill the room.

I’ve had women cry and beg me to help them – to keep the doctor or nurse from doing whatever it is they’re doing to them – and I can’t help at all. Being a bodyguard is outside my professional scope of practice.

I’ve seen a woman say she does not want an episiotomy, and the doctor say “Sorry” (snip, snip, snip)“I had to make some room.”

On one hand, I’m glad I was there to help those women in whatever way I could. On the other hand, it’s terribly stressful having witnessed crimes against women and know that professional secrecy will prevent everyone in that room from discussing what happened to her.

Of course the mother could take this information to the authorities, but that rarely ever happens. On one hand, as long as the mother came out with a healthy baby, nobody cares how she was treated in the process. She would need to have a damaged baby to have any sort of a legal case that an attorney would see worth his/her time. It’s also quite easy for a laboring woman not to remember or understand the details of what was being done to her. She’s in laborland – not taking minutes in a meeting. Women also have a hard time coming to terms with being violated.

This is the same reason so many women don’t report rape. After the incident is over, they just want it to be over. They don’t want to think about it, or drag it through a court system. They may think that it’s partially their fault, or that going public may put their story under embarassing and unfair scrutiny. When I took my VBAC story to the Chicago Tribune, my obstetrician accused women like me of having a “control issue.” No apology. No admission that his behavior was unethical and potentially illegal. He simply blamed me for not submitting to his violation. There are a million reasons women do not report violations, coupled with a million violators who continue to practice the way they do without anyone holding them accountable.

What can be done? At what point can we, who witness these crimes, open this can of worms and start talking about what is happening to individual women every single day in this system of ours? I know that it’s not my place to file complaint about the way a woman was treated, but if there’s no transparency, where does that leave us? I can tell you that it leaves me angry in my bones and feeling sick to my stomach.

In the mean time, I have to decide whether or not I can handle seeing any more of these hospital births, or if I should send women in to the lion’s den without someone like me there to help them in whatever small way I can. It’s a tough decision, and one that I may grapple with for a long time to come.

Wednesday, August 11, 2010

Who knew that to do something so natural as giving birth, in today's society there is so much reading and learning to do in order to let it actually happen as nature intended?! The more I read the better I feel about the choices I am making, to VBAC and to avoid all medications and interventions as much as possible (as long as the baby and I are safe and healthy). But, the medical field is not really content to just let nature take its course many times and what you end up with is a cascade of interventions, which often leads to a c-section as the end result.

What is a cascade of intervention? It is where something that starts out as simple as breaking the water to get labor going snowballs into many interventions... just like what happened to me and caused me to have a c-section. I got a little bit of Pitocin, then my water was broken, which led to horridly unnatural contractions, which made me get the Epidural, which stalled labor.... etc. The problem is that during all of these interventions no one TOLD me what the benefits or drawbacks to each of them was. No one gave me any information, just went ahead and did whatever they thought was best to get me laboring and birthing on the hospital timeline.

I wish that more women knew about the possible (and probable) side effects to letting the nurses and doctors intervene like this... inducing labor for no medical reason, "helping" labor along with Pitocin, offering epidurals too early in labor.... I didn't with my first or second baby. And I am quickly learning that many women don't WANT to know this information. They are comfortable with how medical birthing has become nowadays and get pretty defensive when you try to present the facts of intervening.

It is my hope that at least this blog helps someone out there, whether to question the need for a repeat c-section, to look into more natural methods of pain relief, or just read about how birth is supposed to be- which is NOT how it is shown in movies or popular media!

Friday, August 6, 2010

Now that I have my VBA2C doctor in place and know that I am not going to be forced into having an epidural or other pain meds unless I want them, I am reading everything I can about natural childbirth and pain management.

I like this book because it is very factual and at the same time presents the facts in a way that make it easy to understand, therefore making it easier to make an informed decision about different methods of pain management. The author does not sugar coat the fact that labor hurts, to do so would be slap some rose colored glasses on the reader. However, you are given tools to cope with that pain and listen to it rather than hide it beneath drugs.

The author goes through the various stages of labor from how to tell if you are truly in labor to the end where the placenta is delivered. She talks about the pain medicines available at a hospital, birth plans, labor positions, and so much more.

I really enjoyed reading about various oils that can be soothing for aromatherapy, reflexology, and the benefits of acupuncture for getting labor going. I would highly recommend this book to anyone considering an all natural birth!!

Tuesday, August 3, 2010

I have discovered that if you yell loud enough people take notice, whether they agree or disagree. And if you not only stand your ground but use intelligence to wage your wars, your chances of success are that much higher.... but sometimes it is purely luck that is on you side!

Yesterday, I went to my 3rd OB consult in the hopes of finding a supportive OB so that I could have this baby in a hospital but still have the natural VBAC I am hoping for. I had made the decision to have Klint stay at home because I don't know if I could have undone yet another OB's lies and inflated "your baby and you are going to die for sure" statistics. I had tried to talk myself into a mindset of calm, peace, and non-defensive which was hard considering what I have been through thus far... it helped that I was seriously running through the hospital to find this OB's office... I was too out of breathe to be defensive!

After all the phone calls, all the stress, research, worrying, and distrust of the medical community I have finally found an OB. One who not only did not mention a single uterine rupture statistic, (actually that was not even talked about), he did not tell me my chances of failing were high, or that this is a bad decision. What we did talk about are things that pertained specifically to me and my personal birth history- I am short (4'10'') so that may not help BUT he delivered a woman vaginally who was only 4'8'', it was not noted if my previous OB thought that my pelvic bones were too small- bad because he would like to know BUT good thing because it is purely an OB's opinion and opinions like that vary from doc to doc. He looked at my scar- was completely amazed at how "beautifully" it healed, was confidant that my body can progress when it is ready to deliver, refuses to induce births before 42 weeks, AND has witnessed all-natural VBAC's. OMG!!!!!!!

So here is the lesson learned from this experience- DO NOT settle for anything other than what is BEST for you and your baby. There are good OB's out there who will not make you jump through hoops to have a VBAC (aka the 3 Ring Circus VBAC), who are supportive of natural VBACs, and who are confidant in their abilities to keep you and your baby safe. This OB was referred to me by both the local ICAN chapter, a great resource! And even though his name isn't mentioned, this is his patient mentioned who had 3 c-sections prior to finding him and having successful VBACs!

My new OB blew my mind when he said "I am open-minded and flexible as long as you and your baby are safe and well". Isn't that how ALL OB's should be?

Sunday, August 1, 2010

One of the biggest things that I have learned thus far is that women have the right to say no to interventions and procedures that they feel are not in their best interests. Before I got "that feeling" that something was not right with what my former OB was saying, I honestly thought that the professionals entrusted with my care had my best interests at heart. I did not realize that some OB's choose to lie and manipulate their patients to back up their "facts" and that I had to be the one to do my homework about everything involved in having a baby in modern America. Every childbearing woman in America has rights, which you can read here.
Most providers, I want to believe, will be open and honest regarding the risks and benefits to all the interventions pushed on birthing mothers today. However, there are some who choose to use their "professional" status to bully the patient. This includes brushing off whole topics, inflating statistics to support their opinion, graphic imagery to make a statement, and threats that are meant to stop the patient from questioning further. Unfortunately, for women who are trying for a VBAC and even more so, a VBAMC (vaginal birth after multiple cesareans), these "scare tactics" are pretty common. Here is a great list of the tactics OB's and yes, even some midwives, will use to get a woman to "choose" a repeat c-section.

So what can you do if you are being bullied into interventions that you don't believe are medically necessary? The OB wants to induce you at 38 weeks, you are told you HAVE to have an epidural, the nurses won't let you move around, or you are told that you have no choice but to have a repeat cesarean....

1. Do your homework- there are great websites here that will inform you honestly about the risks and benefits to most of the common interventions such as Pitocin, artificially breaking the water, laboring on your back, etc.

2. Make sure that your partner, doula, midwife, and labor coach know what you want for your birth and even more importantly WHY. When you are concentrating on labor the last thing you need is someone from your labor team pressuring you to go along with whatever suggestions the nurses and such are making!

3. Ask questions- ask what other options there are, ask for a second opinion, ask for time to decide.

4. Go with your gut and listen to your body- if your body is telling you that you need to move then do it, if there is no medical reason for the intervention then decline.

5. Remember that even if you do decline and give your informed refusal to something, you have the right to change your mind.

I know from recent experience that the more informed you are prior to giving birth the more prepared you will be to deal with various situations. I have no clue how this birth will go, what kind of support the hospital staff will give me or if I will have to constantly fight to remain in control of what is happening. But I truly feel that the more knowledge I have about the whole process, the better off me and Miss M will be!

Hi there! My name is Connie and I created this blog to both educate and raise awareness about birth today in modern America. I am currently pregnant with my 3rd little girl and had to search fervently to find an OB provider who will support my goal of a successful vaginal birth after 2 cesareans or a VBA2C. (Luckily at 22 weeks I found one!)

This blog is a log of that journey in the hopes that maybe my fight will help someone else with theirs!